Meaningful Use, does anyone know what it means yet?

The Health IT Policy Committee is supposed to be finalizing and publishing the definition of Meaningful Use for EHRs.  This definition is to be publicly released and available for review.  Basically the committee’s goal was to have a working definition, versus the amorphous definition floating around right now.  It was thought that this would happen this month.  After the issuance of the NPRM [notice for proposed rulemaking] for meaningful use happens, there will be a 60-day window for people to review and comment on the proposed definition, followed by review and any revision before a final definition is reached for release.

The latest HIT Policy Committee Meeting was held December 16th, there is a line item listed as Summary of Approaches for NHIN Meaningful Use in 2011 & Components of the NHIN, but it is the only line item with no information attached.  So either the agenda item was not covered or the notes have not been listed yet (although all of the other items currently contain attached notes).  The committee’s next meeting is not scheduled to be held until Jan 13, 2010.  As far as I can tell, no meaningful use issuance has been made to date.  We’ll keep you posted.

Why is meaningful use important to you?
It’s meaning, as well as the measures they want reported are what you will be using and reporting to obtain any of the promised Stimulus Program funds.

What does the timing look like on the definition and the proposed measures, and when will you be using them? 
It looks like they want to have preliminary measures in place by 2011, with final measures and definitions in place by 2013 to go along with the President’s timeline for EHR implementation by the healthcare masses—you.

In a not un-government like move, they are typically putting the cart before the horse.  They are putting a string of measures together that will need to be measured and reported on by you, the physicians.  These measures will be like the PQRI program, only more extensive.  They are coming up with the measures first and then looking at how they can “retool” them for EHR reporting.  Here is a current example; the NQF (National Quality Forum) is listing over 500 endorsed performance measures.

“Among the currently endorsed measures, the majority of specialties have at least 10 measures per specialty with numerous examples of more robust sets of quality measures.  For example, there are approximately one hundred measures each related to cardiology and surgery; approximately thirty measures related to pediatric care; approximately twenty measures each related to cardiac surgery, endocrine, infectious diseases, nephrology, neurology, emergency medicine, and psychiatry. There are considerably smaller number of measures related to certain specialty areas, such as gastroenterology, pulmonary, rheumatology, and urology.”  http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_11673_907421_0_0_18/Burstin-RQMQA.pdf  (10/27-10/28 meeting notes from the Registries and Quality Measures Panel)

It is definitely looking like EHRs are to be the play-thing that allows government agencies and insurance companies to economically collect the quality measurements and data that they want.  This will allow them to see what you are doing and how you are spending their money, in a cheap and easy way.  They want these measures so that both you and they can be more “cost efficient”.  Their other big key phrase of late is to promote greater “transparency” in government.  Sounds a lot like their reasoning for NPI numbers doesn’t it?  EHRs are primarily for “their” pocketbook control and bottom line, not yours.  This will also allow them to cheaply scrutinize your offices even closer for “inappropriate” anything and everything.  Unfortunately, their rubber carrot enticement for you will be followed by a rather large whip, so like it or not, they are forcing you to get your offices in order.  EHR now, or EHR later, sooner or later they are going to see to it that you have one.

Is it all doom and gloom?
No, it is not.  This is your time to step up and make this an opportunity, a chance for you to bring your office into order.  EHRs can help you to be more efficient, make your mundane processes and excessive reporting easier, and increase your bottom line.  If you make the move to EHR because you want to, you’ll already be there, kicking them back at their own game by the time they figure out their own rules.  You will be unflappable, unassailable, and have pocketed enough of your own money to take a vacation while “they” sweat the details. 

Penny Henriksen
Genius Solution's writer and editor
newsletter2009 @ geniussolutions.com

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